Healthy Eating as a Public Concern: Nutrition policy throughout the UK Helen Crawley Centre for Food Policy Nutrition Policy in the UK • The UK has had no comprehensive national food policy since the second world war, and ‘Ministers of Food’ have only been in place in times of crisis • Post war, the emphasis in the UK, like in much of Europe, was on increasing production of cheap food, use of technology and post- NHS health optimism • The first serious debates about diet impacting on diseases such as heart disease and cancer did not really begin until the early 1980’s • Campaigners like the nutritionist Caroline Walker publicy argued that cheap food was not good for public health – and reports such as the NACNE report in 1983 summarised evidence on the damage that diets high in fat, salt and sugar and low in fibre could do • The first national recommendations on diet related to heart disease were published in 1984 and comprehensive dietary reference values for the UK population were produced in 1991. • Nutrition policy has historically been discussed relative to a nutrient (how much vitamin D?), a population group (what should older people eat?) or a disease (what should you eat to prevent cancer?) • There is no one document that summarises nutrition policy in the UK – it is hidden away in a whole variety of documents and reports Health Inequalities • The role of health inequalities in determining disease became the focus of the new Labour Government’s work around public health from 1997 • At the same time, increasing concern over obesity started to shift public thinking about nutrition and devolution for Wales and Scotland gave those countries their won voice on public health The Scottish Diet Action Plan • Produced in 1985 this report made 71 recommendations for Scotland to improve diet, food knowledge, food provision, food procurement, animal breeding, food in public settings: it was a comprehensive report ahead of its time • Despite all the good intention, little happened before devolution in 2000, after which huge investment was made in trying to improve nutritional health through the implementation of these recommendations – much good work remains in progress but health indicators have not improved Current state of play In the years between 1997 to 2008 there have been important and influential strategies and policies in all 4 UK administrations. A Food and Nutrition Strategy for Northern Ireland (1996) – Fit Futures (2006). Wales - Food and Wellbeing (2003). Quality of Food (2008). Scottish Diet Action Plan (1996), Healthy Eating Active Living Plan (2008), Scotland’s National Food and Drink Policy (2009). England - Choosing a Better Diet (2005) – Healthy Weight; Healthy Lives (2008), Food Matters (2008). Eating for Health: Meeting the Challenge Healthy Eating, Active Living Fit Futures Choosing Health White Paper Food and Well Being Healthy Start Promoting Healthy Diets & Physical Activity Green Paper EC Platform for Action on Diet, Physical Activity and Health UK and international policies Food Matters • An attempt to bring together all the elements of a new food policy for the UK • It highlighted all the current policies relating to food across the UK and the many different initiatives in place • It acknowledged however : …..’there is much more to be done to address the public health and environmental issues arising from food consumption, and a need to do so in a joined-up way’ Nutrition Policy focus in the 21st century . Obesity became a real public health issue around 2000 and since that time many nutrition policies have been combined with physical activity programmes - and significant funds have gone into research and obesity prevention programmes across the UK. The Foresight Report is the basis of the Healthy Weight Healthy Lives programme in England Change4Life is the £75million 3 year public health programme in England which uses social marketing techniques to encourage people to ‘eat well and move more’. Impact? • Awareness of the Campaign is reported to be high and many families have ‘signed up’ for information • It is well liked at grassroots level and the imagery is being adopted across the country • It is suggested that those that have signed up report changing their behaviours one million mums claim to have attempted to change their children's behaviour as a result of Change4Life ‘Swap it – don’t stop it’ • The new campaign aimed at adults in 2010 suggests that you can make simple swaps – rather than avoid particular foods and drinks altogether • Critics of the campaign say it lacks clarity about what eating well really looks like, does not link with other campaigns and issues and makes no links to wider food issues such as sustainability What has happened since Food Matters? Links between nutrition policy and environmental issues are now being looked at together – for example in developing a Healthier Food Mark for caterers. We are still a long way from being able to produce a national eco-nutrition policy – but we do now have big players debating the issues and ‘food policy’ will be firmly on the agenda for the next election. We have a Council of Food Policy Advisors and two of their three priority areas are defining an environmentally sustainable healthy diet and producing a UK wide fruit and vegetable strategy Where have we had nutrition policy success? • We have regulation for school meal nutritional standards in England, Scotland and Northern Ireland – Wales is still doing pilot work on their standards. Free school meals for all is in serious discussion • We are starting the process in England to bring in similar regulation (?) for food in early years settings (children under the age of 5 in the UK) • Healthy Start is UK wide and has extended the welfare food scheme to fruit and vegetables for low income families 2010 report card on nutrition policy for the UK • Lots of action and commitment overall – nutrition is high on the agenda • Focus on obesity remains strong • Emphasis on work on key areas such as salt, saturated fats: industry reformulation, healthy choice initiatives; food labelling – all voluntary initiatives with industry • Schools work seen as a success • A growing awareness that ‘less meat and dairy’ might become policy options • Acknowledgement that nutrition policy is part of wider food policy But ….. • Lots of policy and policy promises - and repetition by multiple agencies • Joined up action often missing e.g. schools can be funded from many sources or even different funds within the same department. • Regulation not favoured in many areas • The reemergence of the food industry as key players aided by the sustainability agenda • Little work on food poverty and welfare with lack of policy for the changing economy and credit crunch. • The lack of a public health (population) approach: much policy development left to charities and NGO to do and campaign for; huge variability across each country Useful UK NGO/Charities to look at doing work around food, farming, nutritional standards: • Sustain • www.sustainweb.org • The Caroline Walker Trust • www.cwt.org.uk